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October 10, 1977

Botulism and Sudden Infant Death Syndrome

JAMA. 1977;238(15):1629. doi:10.1001/jama.1977.03280160023008

To the Editor. —  In their article on infant botulism (237:1946, 1977) Arnon et al state that initial diagnosis of infant botulism included failure to thrive, sepsis, dehydration, viral infection, idiopathic hypotonia, myasthenia gravis, poliomyelitis, meningitis, brain stem encephalitis, neoplastic disease, acute infantile polyneuropathy, and various hereditary and metabolic disorders.This same list of disease entities could also refer to some of the proposed causes of sudden infant death.1We have believed for some time that botulism is related to some cases of sudden infant death and have implicated the food source.2 And the very fact that there have been no reported cases of infant botulism causing death leads us to believe that some cases of sudden infant death have indeed been caused by this agent. Certainly it is odd at best that between 1962 and 1967 the national Communicable Disease Center (CDC) reported no deaths in ten cases